Pyotr Borisovich Gannushkin (; March 8, 1875 – February 23, 1933) was a Russian psychiatrist who developed one of the first theories of psychopathies known today as personality disorders.Ганнушкин П. Б. (2000). Клиника психопатий, их статика, динамика, систематика. Издательство Нижегородской государственной медицинской академии. . He was a student of Sergei Korsakoff and Vladimir Serbsky. Not only did he manage to delineate certain organizational tasks of social psychiatry, but he also clearly formulated the main methodological aim of social psychiatrists, to combine methods of individual clinical analysis with sociological research and generalization.Банщиков В. М. Большой друг больного (К 100-летию со дня рождения П. Б. Ганнушкина) // Здоровье. — 1975. — № 3. — С. 32.Вольф М. Ш., Гериш А. Г. Материалы к врачебной, научной и педагогической деятельности соратников и учеников П. Б. Ганнушкина // Проблемы бреда, пограничные состояния и вопросы организации психиатрической помощи: Тезисы научной конференции, посвящённой 100-летию со дня рождения проф. П. Б. Ганнушкина (г. Москва, 29–30 июня 1975 г.) / Под общ. ред. М. Ш. Вольфа. — М.: Б. и., 1975. — С. 80–89.
Formative Years
Early life and education
Pyotr Borisovich Gannushkin was born in the Russian Empire in 1875 in the village of Novosyolki in the Pronsk district of the Ryazan Governorate (the present-day Ryazan Oblast). His father Boris was a physician, a compassionate and precise man. His mother Olga (née Mozharova) came of an impoverished Russian landed family. Well-bred and educated, she was fluent in French and German, interested in philosophy, and fond of music, poetry and art. She was, moreover, a gregarious and kind-hearted woman.Баженов Н. Н. История Московского доллгауза. — М., 1909. — С. 9.Гериш А. Г. Библиографическая хроника профессора П. Б. Ганнушкина // Проблемы бреда, пограничные состояния и вопросы организации психиатрической помощи: Тезисы научной конференции, посвящённой 100-летию со дня рождения проф. П. Б. Ганнушкина (г. Москва, 29–30 июня 1975 г.) / Под общ. ред. М. Ш. Вольфа. — М.: Б. и., 1975. — С. 61–72.
In his early years, Pyotr was educated by his mother. After a while, the family moved to Ryazan, the regional capital, where his father started teaching at a high school for boys. Soon after his 9th birthday, the young Gannushkin enrolled at the same school. An excellent student, Pyotr was always sociable, honest, and inclined to irony; he nursed a dislike for severe discipline. During his school years, he edited his own home journal.Гериш А. Г. П. Б. Ганнушкин. — М.: Медицина, 1975. — 64 с.
Gannushkin's sister Maria noted in her memoirs that Pyotr never told anyone which profession he intended to pursue. When he turned 13, however, Gannushkin's keen interest in "personology" and human mentality became apparent. It was then that he read Sechenov's 1863 monograph "Brain Reflexes", a successful attempt to describe the physiological mechanisms of mental activity.
University years
In 1893 Gannushkin graduated from the high school with a gold medal, the highest award, and entered the department of medicine at Moscow State University. In his third year of studies, he finally decided to become a psychiatrist after being influenced by such university professors as Aleksei Kozhevnikov and Sergei Korsakoff.
All the students, including Gannushkin, were fascinated by the way Korsakoff interacted with the mentally disabled. As Korsakoff explained, "mental patients should not be regarded as soulless creatures: they should be considered personalities familiar to everyone who is somehow related to them."Завилянський І. Я. Пам’яті професора П. Б. Ганнушкіна, до 25-річчя з дня виходу в світ книги «Клініка психопатій» // Збірних наукових праць, присвячених 150-річчю Київської психоневрологічної лікарні (1806–1956). — Київ: Б. в., 1959. — Т. 1. — С. 293–299.
In addition to attending lectures and recitals during his university years, Gannushkin served as an orderly with the responsibilities of a junior medical staff member.Зейгарник Б. В. Пётр Борисович Ганнушкин и патопсихология // Проблемы бреда, пограничные состояния и вопросы организации психиатрической помощи: Тезисы научной конференции, посвящённой 100-летию со дня рождения проф. П. Б. Ганнушкина (г. Москва, 29–30 июня 1975 г.) / Под общ. ред. М. Ш. Вольфа. — М.: Б. и., 1975. — С. 98–100.Зиновьев П. М. Основные этапы научной работы П. Б. Ганнушкина // Советская невропатология, психиатрия и психогигиена. — 1933. — Т. 2, вып. 5. — С. 3–6.
Career and Biography
Gannushkin graduated from Moscow University in October 1898. He turned down a proposal to become a permanent resident physician, because it then included superintendent's responsibilities. During the next years, up to 1902, he was a non-resident of the psychiatric hospital. He worked in the outpatient clinic and wrote a variety of scholarly works.
In 1901, for example the French journal Medico Psychological Annals () he published a monograph called "Voluptuousness, cruelty and religion" (), which was subsequently banned in Russia. In it Gannushkin emphasized the close relation between religiosity, sexuality, and cruelty, using the example of Ivan the Terrible as an illustration. In many cases religious fanatics demonstrated cruelty, wrote Gannushkin, and vice versa, i.e. many cruel people were religious.Gannouchkine P. B. La volupté, la cruauté et la religion // Annales médico-psychologiques. — 1901. — V. 14. — P. 353–375.Кербиков О. В. Проблема психопатий в историческом освещении. Сообщение третье: Учение о психопатиях в работах П. Б. Ганнушкина // Журнал невропатологии и психиатрии им. С. С. Корсакова. — 1958. — Т. 58, вып. 10. — С. 1253–1258.
In 1902, at the suggestion of Sukhanov, Serbsky, and Rossolimo, Gannushkin was made a full member of the Moscow Society of Neuropathologists and Psychiatrists (). At the same time, he was elected a supernumerary assistant at the psychiatric hospital headed by Serbsky, after Korsakoff's early death from heart failure.
Collaboration with Sergei Sukhanov Korsakoff's assistant Sergei Sukhanov was willing to help young physicians, fostering them in word and in deed. Sukhanov was a proponent of the nosological approach. He demonstrated a remarkable power of observation. Borderline psychiatry, especially psychopathies and psychogenies, was among his main research interests. His inclination towards synthesis led Sukhanov to note both the scientific and social importance of this problem.
Sukhanov managed to stir Gannushkin's interest in these issues and the two developed friendly relations, publishing six research papers together. They preferred to study individual mental disorders rather than their mixed types, believing that this approach would contribute to the study of acknowledged diseases, the discovery of new mental disorders, and the development of psychiatric taxonomy. Sukhanov and Gannushkin distinguished a particular form of obsession and were the first to show the process whereby, at least in some cases, obsessions were transformed into schizophrenia.Каннабих Ю. В. История психиатрии. — М.: Госмедиз, 1929. — С. 466–468.
Acute paranoia (1904)
In 1904, Gannushkin submitted his thesis on "Acute paranoia" (). It took the form of a sketch of the historical development of the theory of acute paranoia. The thesis opened with a description of the research of Vincenzo Chiarugi and Jean-Étienne Dominique Esquirol. The focus then shifted to works by Wilhelm Griesinger, Bénédict Morel, and Karl Friedrich Otto Westphal. Next Gannushkin presented observations made by Sergei Korsakoff, Vladimir Serbsky, Emil Kraepelin, and Eugen Bleuler. Finally Gannushkin gave a brilliant exposition of his own findings about paranoia.Кондрашкова О. В., Вольф М. Ш., Лурия Л. Р. Пётр Борисович Ганнушкин и психиатрическая больница, носящая его имя // Проблемы бреда, пограничные состояния и вопросы организации психиатрической помощи: Тезисы научной конференции, посвящённой 100-летию со дня рождения проф. П. Б. Ганнушкина (г. Москва, 29–30 июня 1975 г.) / Под общ. ред. М. Ш. Вольфа. — М.: Б. и., 1975. — С. 25–41.
After his thesis was accepted and approved, Gannushkin became a privat dozent (i.e. freelance university lecturer) of the Department of Mental Disorders in the Moscow State University. It was then that he began to deliver his course of lectures on "The Theory of Pathological Characters" ().
In 1905, Gannushkin attended courses in postgraduate psychiatry at Kraepelin's clinic in Munich. Thereafter he became a proponent of Kraepelin's theory. The following year, Gannushkin visited St. Anne's Psychiatric Hospital () in Paris, where he familiarized himself with the work of Valentin Magnan, an influential figure in French psychiatry. In 1908 and in 1911 Gannushkin again attended postgraduate psychiatry courses at Kraepelin's clinic.
Resignation (1911) and post-Revolutionary career
In 1911 university autonomy became a crucial issue in Russia, leading to repressive measures by the Tsar's protégé Lev Kasso, the education minister. In 1911, together with other progressive scholars and scientists, Gannushkin left the university in protest. From 1906 until 1914, when he was drafted into the army, he worked as a resident physician at the Moscow Alexeyev Psychiatric Hospital (), known today as the Kashchenko Mental Hospital (). During this period Gannushkin and others set up a first-class research journal, The Korsakoff Journal of Neuropathology and Psychiatry ().
In 1917, after being discharged from the army for health reasons, Gannushkin returned in the Moscow Alexeyev Psychiatric Hospital. From 1918 onwards he was a professor in the Department of Psychiatry at the Moscow State University (from 1930 he was professor at the I.M. Sechenov First Moscow State Medical University) and director at the University Psychiatric Hospital: today this is known as the Korsakov Clinic of Psychiatry at the Sechenov Moscow Medical Academy ().
Some other aspects of his work
Gannushkin was one of the first psychiatrists to talk about the schizoid reaction type, the somatogenic and psychogenic reactions of schizoids.
In 1927, he identified the "epileptoid reaction type", which is usually characterized by repeated temporary reactions caused by the influence of psychogenic factors and unfavorable situations. This reaction type is expressed by symptoms of dysphoria, i.e. malicious actions combined with anger, anguish, and fear.Ганнушкин П.Б. Об эпилептоидном типе реакции. Вестник современной медицины, 1927; № 23.- С. 1472–1473. In many ways, this reaction type is akin to the behavior pattern typical for borderline personality disorder. As a psychotic episode, such reactions could happen during epidemic encephalitis, cerebral atherosclerosis, and brain injury.
Gannushkin also took part in the experimental study of hypnosis. He criticized Lombroso's theory of crime.Галачьян А. Г. К неопубликованным работам П. Б. Ганнушкина // Ганнушкин П. Б. Избранные труды / Под ред. О. В. Кербикова. — М.: Медицина, 1964. — С. 255–256.
Gannushkin was interested in psychoanalytical ideas, and made experimental use of psychoanalytic therapy. His stance on psychoanalysis is outlined in his "On Psychotherapy and Psychoanalysis" ().Ганнушкин П. Б. О психотерапии и психоанализе // Ганнушкин П. Б. Избранные труды / Под ред. О. В. Кербикова. — М.: Медицина, 1964. — С. 283–284. Not a committed proponent of Freud's theory, Gannushkin did believe that under certain conditions psychoanalytical methods could be used as part of the process of treatment.Фридман Б. Д. П. Б. Ганнушкин в учении о психопатиях // Советская невропатология, психиатрия и психогигиена. — 1933. — Т. 2, вып. 5. — С. 106–111.